Hepatitis G virus RNA positivity among the voluntary blood donors: a summary

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Hepatitis G virus RNA positivity among the voluntary blood donors: a summary

Copyright © 2005: Mexican Association of Hepatology

ANNALS OF HEPATOLOGY

Number 1 January-March 2 0 0 5

Volume 4

V Wiwanitkit. Hepatitis G virus RNA positivity among the voluntary blood donors

MG

43

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Annals of Hepatology 2005; 4(1): January-March: 43-46

Annals of Hepatology

1_{Department of Laboratory Medicine, Faculty of Medicine,} Chulalongkorn University, Bangkok Thailand 10330.

Address for correspondence. Viroj Wiwanitkit

Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 10330 Email: [email protected]

Manuscript received 4 November, 2004 and accepted 24 November, 2004

Abstract

Hepatitis virus infection is an increasing problem.

Mil-lions of humans all over the world are infected. Viral

hepatitis is accepted as a significant public health

problem with several life altering complications.

Re-cently, new viruses have been identified for their

asso-ciation with hepatitis. Hepatitis G virus (HGV) is a

single stranded RNA virus which represents a newly

discovered virus belonging to the flavivirus family.

Epidemiological data indicate that the virus is

trans-mitted via blood/blood products, sexually and

vertical-ly from infected mothers to children. There are some

previous reports on the prevalence of HGV infection

among the blood/blood products. The purpose of this

study is to summarize the prevalence of HGV

infec-tion, defined as HGV RNA positivity, among the

vol-untary blood donors in the previous reports. Due to

this study, there have been at least 30 reports. Of

13,610 documented voluntary donors, there are 649

cases with HGV RNA positivity. The summative

per-centage for HGV RNA positivity is 4.8%: 4.5% in

Caucasian, 3.4 % in Asian and 17.2% in Negroid.

There is no significant association between ethnicity of

donors and prevalence of HGV RNA positivity (p >

0.05). The HGV infection seems to distribute in all

eth-nicities all over the world, implying the global

impor-tance of this hepatitis virus infection. Screening for

HGV RNA might be an important test in blood bank

process in the future.

Key words: HGV, prevalence, blood donor.

Original Article

Hepatitis G virus RNA positivity among the

voluntary blood donors: a summary

Viroj Wiwanitkit

Introduction

Hepatitis virus infection is an increasing problem.

Mil-lions of humans all over the world are infected. It is

ac-cepted as a significant public health problem with several

life altering complications. Five viruses are usually

asso-ciated with hepatitis in humans: hepatitis A virus, hepatitis

B virus, hepatitis C virus, hepatitis D virus and hepatitis E

virus.

_{In addition to these viruses, Sehgal and Sharma}

said that there remained a number of patients with

hepati-tis in whom no virus could be identified and it was

there-fore postulated that there might be other agents, which

might cause hepatitis.

_{Recently, new viruses have been}

identified for their association with hepatitis. Hepatitis G

virus (HGV) is a single stranded RNA virus which

repre-sents a newly discovered virus belonging to the flavivirus

family.

_{Firstly, hepatitis G virus (HGV) and GB virus}

type C (GBV-C) were independently discovered,

howev-er, it was later determined that they were two isolates of

the same virus.

HGV replicates in peripheral blood cells, while

repli-cation in liver cells has not been observed till date.

Di-agnosis of HGV viremia is mainly by polymerase chain

reaction (PCR). Epidemiological data indicate that the

vi-rus is transmitted via blood/blood products, sexually and

vertically from infected mothers to children.

_{There are}

some previous on the prevalence of HGV infection among

the blood/blood products. The purpose of this study is to

summarize the prevalence of HGV infection, defined as

HGV RNA positivity, among the voluntary blood donors

in the previous reports.

Materials and methods

Annals of Hepatology 4(1) 2005: 43-46

44

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According to the literature review, 30 available

re-ports

_{were recruited for further study. The prevalence}

of HGV infection from each included reports was

collect-ed. Descriptive statistics, including range and percentage,

were used in summative analysis. In metanalysis, pooled

prevalence from all reports was calculated. Pooled

preva-lence for each ethnic group (Caucasian, Asian and

Ne-groid) was also determined. In addition, Chi Square test

was performed to assess the association between ethnicity

of the subjects and prevalence of infection. All the

statisti-cal analyses in this study were made using SPSS 7.0 for

Windows Program.

Results

Due to this study, there have been at least 30 reports

(Table I). Of 13,610 documented voluntary donors, there

are 649 cases with HGV RNA positivity (Table I). The

summative percentage for HGV RNA positivity is 4.8%:

4.5 % in Caucasian, 3.4% in Asian and 17.2% in Negroid

(Figure 1). There is no significant association between

ethnicity of donors and prevalence of HGV RNA

positivi-ty (p > 0.05).

Discussion

HGV is a newly discovered hepatitis virus.

_Infection

with this virus is common and frequently persists in

hu-mans.

_{Similar to many hepatitis viruses, transfusion of}

viremic blood/blood product can be the route of this viral

infection. Luckily, HGV infection is not detected to

asso-ciate with serious manifestation because this virus is not

strongly associated with acute or chronic hepatitis.

Fur-ther researches for the possible diseases caused by this

vi-ral infection have been continuously performed.

Although it seems to be rather unlikely, it still remains

unclear whether hepatitis G virus (HGV) is involved in

post-transfusion hepatitis.

_{Hitzler and Runkel said that}

transmission of HGV by blood components did occur and

persistence of HGV viremia was common.

_{Halarsz et al}

noted that recent data indicating that HGV infection might

infect as well as replicate in hepatocytes and might lead to

some presently unknown long-term complications.

Screening for HGV RNA in the donated blood can be a

good tool to detect viremia and prevent for HGV

trans-mission by blood transfusion.

_{Although the HGV}

con-tamination in blood and blood products is already known

Table I. Reports on the prevalence of HGV infection among the voluntary blood donors.

Author Setting* Number of donors Rate of HGV RNA positive (%)**

Stark et al 3 _Germany1 _{90 2}

Orito et al 4 _Japan2 _{200 0.5}

Hwang et al 5 _Taiwan2 _{66 3}

Jongerius et al 6 _{The Netherlands}1 _{250 1.2}

Tacke et al 7 _Germany1 _{80 2.5}

Levi et al 8 _Brazil1 _{545 9.7}

Jeon et al 9 _Korea2 _{110 1.8}

Oliveira et al 10 _Brazil1 _{241 7.1}

Yan et al 11 _China2 _{203 15.8}

Yu et al 12 _Taiwan2 _{500 3.4}

Nordbo et al 13 _Norway1 _{1,001 2.5}

Al-Ahdal et al 14 _{Saudi Arabia}2 _{200 2}

Brojer et al 15 _Poland1 _{219 3.2}

Love et al 16 _Iceland1 _{370 3.8}

Oubina et al 17 _Argentina1 _{200 5.5}

Konomi et al 18 _Bolivia1 _{574 14.6}

Cesaire et al 19 _{French West Indies}1 _{221 4.1}

Sathar et al 20 _{South Africa}3 _{232 18.9}

El-Zayadi et al 21 _Egypt3 _{354 16.1}

Sauleda et al 22 _Spain1 _{2,210 1.9}

Cantaloube et al 23 _France1 _{1,660 2.6}

Minton et al 24 _UK1 _{100 1}

Blair et al 25 _UK1 _{1,020 2.25}

Hyland et al 26 _Australia1 _{565 13.3}

Wang et al 27 _Taiwan2 _{1,500 2.1}

Lampe et al 28 _Brazil1 _{87 10}

Shev et al 29 _Sweden1 _{62 22}

Prati et al 30 _Italy1 _{200 1.5}

Loiseau et al 31 _France1 _{500 4.2}

Wu et al 32 _Japan2 _{50 2}

*Ethnicity of the donor:1 _{means Caucasian,} 2 _{means Asian and} 3 _{means Negroid.}

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sustraídode-m.e.d.i.g.r.a.p.h.i.c

cihpargidemedodabor

there is no appraisal on its global distribution. No

assess-ment for the pattern of HGV infection in donors from

dif-ferent ethnics is performed. Indeed, the ethnical

predomi-nance of viral hepatitis, very high prevalence of hepatitis

B infection among Asian as an example, is mentioned.

Here, the author reports the summative prevalence of

HGV RNA positivity from screening of voluntary blood

donors. The prevalence of HGV viremia in this study is

about 5%. Of interest, the rates of viremia are similar

be-tween the Caucasian and Asian, but the rate is higher

among the Negroid. However, there is no significant

asso-ciation between ethnicity and positivity. The HGV

infec-tion seems to distribute in all ethnicities all over the

world, implying the global importance of this hepatitis

vi-rus infection. Screening for HGV RNA might be an

im-portant test in blood bank process in the future.

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